As we emerge from the pandemic, refocus on well-being, and reconnect to our passion and purpose, the leaders that deserve recognition and expressions of gratitude are nurse managers. These leaders bore the brunt of the chaos of the last 3 years and are now facing unrelenting staffing shortages and a health system in desperate need of change. The toll of 24-hour accountability for operations, patient outcomes, staff engagement, maintaining a healthy work environment, etc, has reached a tipping point. Nurse managers are accountable to recruit, retain, and create a culture of trust, excellence, and performance.1,2 In other words, they are the underpinning of what matters most, healthcare at the point of care.
The Challenge
The August 2021 American Organization of Nurse Leaders (AONL) pulse survey revealed deterioration of front-line leader well-being that 1 in 3 nurse managers was not in a state of emotional good health, nurse managers felt their contributions went unrecognized, and 20% of nurse managers were contemplating leaving their roles.3 Investing in the well-being of nurse managers is the only way forward.
The AONL and DAISY Foundations joined forces for a call for action. During multiple focus groups, nurse managers validated their lack of regular recognition and gratitude, particularly from leaders in the C-suite. Of the 5500 DAISY hospitals and healthcare facilities that regularly honored nurses, only 400 recognized nurse leaders with the DAISY Award, demonstrating the scope of the gap. While the AONL and DAISY Foundations set forth a plan to create a sustainable system to recognize nurse managers, AONL kicked off a national effort to redesign the nurse manager role.
Using feedback from focus groups and with funding from 2 industry partners, the AONL and DAISY foundations launched a national campaign called Beyond Gratitude: A Tribute to Nurse Managers in February 2022.4 A multimedia campaign was launched, and a specially created website provided free, customizable toolkits for healthcare organizations, and links to QR codes for DAISY Nurse Leader Award nominations were placed in toolkits and were widely distributed.
Beyond Gratitude: What Happened?
Over 10 000 viewers used the site within its first 3 months, and there were 142 000 impressions. The provision of free and accessible mechanisms for expressing gratitude worked. DAISY experienced an 81% increase in orders for the Nurse Leader Award. Recognition of front-line nurse leaders occurred in large and small organizations in virtually all specialties around the United States.
Below are several of the very touching and heartfelt words of gratitude:
For 4 years, Shannon Seitz, MSN, RN, PCCN, has led her team as the nurse manager at the University of Pittsburgh Medical Center. She is visible and supportive and never hesitates to lead by example as during the transition of her orthopedic unit to a COVID unit and then back to an orthopedic unit. When staff was temporarily reassigned, Shannon worked closely with the receiving unit to ensure a smooth transition. Throughout the pandemic, the unit maintained a center of excellence designation, achieved the 92nd percentile for HCAHPS, and received top marks in nurse bundle scores.
Ling Tieu, MS, RN CMSRN, assistant manager at UC Davis Medical Center, was honored because of her authentic leadership and launching a hospital-wide age-friendly program for elders, which led to a 50% reduction in patient falls, a 5.8-day decrease in the length of stay of older adults with a delirium diagnosis, and a 43% reduction in restraint use.
M. Stephanie Minervini, MSN, RN, CCRN, the interventional cardiac care nurse manager at Riverview Medical Center in New Jersey, inspires her team to dream more, learn more, and do more. Since assuming her leadership role, the working environment has dramatically improved, turnover has decreased, and unit morale is at an all-time high. In a recent Trust Index Survey, Stephanie's team gave her an impressive 97% rating. Increases in staff satisfaction led to improvements in patient satisfaction, and her team state that Stephanie leads by example
Vicky Canellas, a nurse manager at Memorial Hospital in Florida, is described as a silent warrior, an expert critical care nurse, and an expert nurse manager. She led a group of critical care professionals through the COVID-19 pandemic and consistently made the impossible possible. Vicky organized, adjusted, educated, re-adjusted staffing, adjusted again, opened remote critical care units, moved critical care units, changed nursing processes, adjusted clinical practice, educated staff of every practice change every day, and was present every day. Vicky demonstrated a leader's power and made a positive difference for all.5
A Ray of Hope
A ray of good news came in October when the 4th AONL Pulse Survey revealed that the health and well-being of nurse managers had modestly improved, and more leaders said that "if they did the best job, the organization would notice."6 Two additional studies released in October add understanding. Feedback from Remesh focus groups provided further insight into the joy and power of meaningful recognition.7 Joseph's8 qualitative study provided a framework for creating a culture of meaningful recognition, which includes the 2 primary drivers of the "relational way of being" and "validation of the role and supportive structures and supportive processes". In each report, meaningful recognition was tied to purpose and associated with joy for nurse managers.
Going Forward
The "Tribute to Nurse Managers" also includes "Beyond Gratitude." Although gratitude and tribute are necessary, redesigning the environment and infrastructure within which the nurse manager can excel and experience joy and fulfillment is critical. In 2023, AONL will publish through phased releases a compendium of innovative practices, podcasts, webinars, and recommendations on the redesign of the role of the front-line nurse manager. Recommendations on span of control, administrative support, flexibility, and issues contributing to their intent to leave their positions will be included. The campaign "Beyond Gratitude: A Tribute to Nurse Managers" is building in the structures and processes to enable all nurse managers to excel and feel fulfilled.
Regular expressions of gratitude and meaningful recognition with the DAISY Award for Nurse Managers can help create the reserve needed to sustain extraordinary nurse managers. Going beyond gratitude to create meaningful changes in nurse managers' lives will create healthy environments for all. Beyond Gratitude: A Tribute to Nurse Managers illustrates how the power of a partnership of 2 foundations can make a difference.
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